Confused

[Suecon]

Hi, me again. I've been taking anti inflammatories for a neck injury for many years, and antihistamines for numerous allergies. Can either of these suppress lupus symptoms or affect blood tests? Many thanks x

[Barnclown]

Hello sue: good question...I was on prescription NSAIDs & analgesics daily for my cervical spine condition during many years while my infant onset lupus diagnosis was lost....& i have been wondering the same thing (especially cause those NSAIDs never helped much...just made me feel like a zombie)

For what it's worth, here is what the British Society of Rheumatology 2016 guidelines for the management of systemic lupus in adults say re NSAIDs:

NSAIDs in mild SLE

Summary: There are no RCTs of NSAIDs in SLE. Publications support the cautious use of NSAIDs for short periods of time for symptom control in SLE (inflammatory arthralgia, myalgia, chest pain and fever) where potential benefit outweighs the known risks of NSAIDs and paracetamol has been insufficient or not tolerated. The risk of NSAID-induced acute renal failure is increased in patients with lupus nephritis and so NSAIDs should be avoided in patients with renal involvement. NSAID-induced allergic reactions, aseptic meningitis, cutaneous reactions and hepatotoxicity are increased in SLE patients. Caution is required in pregnancy(27).

Evidence: A review of the literature on non-selective Cox inhibitors and selective Cox-2 inhibitors(216) highlighted the potential increased risk of renal, hepatic and neurological toxicity in lupus patients. A retrospective case series assessing celecoxib with a detailed literature review of NSAIDs (217) and a more comprehensive systematic review addressing the risk benefit ratio of non-selective and selective inhibitors of cyclooxygenases in SLE patients were published subsequently(218). More recently it is has become clear that NSAIDs can predispose to acute myocardial infarction in individuals with coronary heart disease (219) which is an additional reason for caution in lupus patients.

Conclusions: based on 1 systematic review of the evidence from case series and case reports, the overall level of evidence for NSAIDs in non-renal mild lupus is 3 and grade of recommendation is D.

😆 am still wading through the guidelines trying to figure out the significance these 'grades', but the blurb gives some indication, 😉. No doubt the blurb explains why my mefenamic acid info leaflet says SLE patients must only take the powerful NSAID mefenamic acid under close guidance & monitoring by medics (I take it as necessary for endometriosis pain & migraine)

Am looking forward to following this discussion

🍀🍀🍀🍀 coco

PS here is the link to the BSR guidelines doc:

rheumatology.org.uk/include...

[Suecon in reply to Barnclown]

That's interesting, thank u x

[Barnclown in reply to Suecon]

👌👌👌👌 I hope someone joins in with more info & experience of whether NSAIDs can affect bloods results joins in your discussion. Thanks for asking your question...I've been wondering about this for YONKS 🍀😘

[Hidden]

Hi there,

It might be a good idea to speak with your GP and ask for new tests if you think you could have lupus. Your GP should be aware of the medications you are taking and will take them this into account when planning your tests and considering their results

.

[copdber]

I don't normally post but felt I had to respond to this. Diagnosed with S L E in 2008 I was out on plaquenil a few months later a NSAID called vimivo was added over time a lot of other meds were added. I had my bloods checked every 2/3 months. 2 years ago I started to get almost continuous kidney infections. A short while back I was unwell and went to my go she was on holidays and I saw a new dr she went through my recent bloods and discovered my kidneys were under sever pressure. She went through my meds and told me to stop taking the vimivo. Since then my kidney function has improved a little. I waiting to see the kidney specialist the moral of the story is be careful with long term use of NSAID and if you regularly see the same gp make sure they're checking your test results properly. I know my gp always seemed to scan my test results looking for white cell count and inflammatory markers. Once they were OK I think the rest was ignored.

[Suecon in reply to copdber]

Thanx x